荧光素钠注射液致过敏试验阴性患者过敏性休克2例

Anaphylactic shock induced by fluorescein sodium injection in 2 patients with negative anaphylactic test

2例眼科门诊患者(例1女,61岁,缺血性视神经病变;例2男,63岁,右眼玻璃体出血)在排除禁忌证、签署知情同意情况下行荧光素钠眼底血管造影检查。2例患者既往均无药物过敏史和心脏病史,肝、肾功能正常。造影前先给予荧光素钠稀释液静脉注射进行过敏试验,观察5 min后结果均为阴性,即给予荧光素钠注射液静脉注射。2例患者分别于注射后2 min和17 min出现过敏性休克症状,血压分别下降至50/32 mmHg(1 mmHg=0.133 kPa)和49/36 mmHg;例1出现一过性房颤,例2患者一度心率为0。经抗过敏、抗休克治疗后,2例患者血压和心率均逐渐恢复正常。

Fundus fluorescein angiography was performed in the 2 ophthalmic outpatients(patient 1,a 61-year-old female with ischemic optic neuropathy;patient 2,a 63-year-old male with vitreous hemorrhage in the right eye)after exclusion of contraindications and signing of informed consent.Both of them had no history of drug allergy and heart disease,and their liver and kidney functions were normal.Before angiography,allergy tests were performed by intravenous injection of fluorescein sodium diluent.After 5 minutes of observation,the test results in the 2 patients were all negative.Then fluorescein sodium injections were given intravenously.The 2 patients developed anaphylactic shock about 2 minutes and 17 minutes after injections.Their blood pressure decreased to 50/32 mmHg and 49/36 mmHg,respectively.The patient 1 had transient atrial fibrillation and the patient 2 once had a heart rate of 0.After anti-allergic and antishock therapy,the blood pressure and heart rate in the 2 patients gradually returned to normal.